ALTAIR INTEGRATIVE WELLNESS NPI 1932744836

NPI Information

NPI: 1932744836
Provider Name: ALTAIR INTEGRATIVE WELLNESS
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 02D2214567

Address:
3161 E PALMER WASILLA HWY STE 1C
WASILLA, AK
ZIP 99654
Phone: (907) 357-1818
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ALTAIR INTEGRATIVE WELLNESS is a multi-specialty clinic center in Wasilla, AK. ALTAIR INTEGRATIVE WELLNESS NPI is 1932744836. The provider is registered as an organization entity type.

The provider's business location address is:

3161 E PALMER WASILLA HWY STE 1C
WASILLA, AK
ZIP 99654-271
Phone: (907) 357-1818
Fax: (907) 357-1814

The provider's authorized official is Tara E Workman Dc .
The authorized official title is Ceo and has the following contact phone number (907) 357-1818.

The CLIA number assigned to this NPI record is 02D2214567 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/14/2019 and was last updated on 12/30/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes
2	363LF0000X	Nurse Practitioner	Family			No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1636141	MEDICAID	ALASKA
2	1633093	MEDICAID	ALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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